TY - JOUR
T1 - A trauma-focused intensive outpatient program integrating elements of exposure therapy with acceptance and commitment therapy
T2 - Program development and initial outcomes
AU - Ramirez, Melissa W.
AU - Woodworth, Craig A.
AU - Evans, Wyatt R.
AU - Grace, Gerard A.
AU - Schobitz, Richard P.
AU - Villarreal, Sara A.
AU - Howells, Christopher J.
AU - Gissendanner, Roy D.
AU - Katko, Nicholas J.
AU - Jones, Kelli N.
AU - McCabe, Amanda E.
AU - Terrell, Donna J.
N1 - Funding Information:
The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army or the Department of Defense or the U.S. Government.
Publisher Copyright:
© 2021 Association for Contextual Behavioral Science
PY - 2021/7
Y1 - 2021/7
N2 - A Performance Improvement project conducted within Army Behavioral Health identified significant challenges associated with treating service members diagnosed with posttraumatic stress disorder (PTSD) including unavailability of frequent and consistent therapy, a low completion rate of evidence-based treatment, and a high non-response rate. In response to these findings, clinical staff at Brooke Army Medical Center developed an intensive outpatient program for the treatment of PTSD and combined Acceptance and Commitment Therapy with Prolonged Exposure therapy to create an integrative and uniquely tailored intervention. This project included 311 active duty service members who had not made significant progress in individual outpatient therapy for PTSD. Each participant completed pre- and post-treatment measures of symptoms, functioning, and processes related to psychological flexibility. Program evaluation also included participant interviews, survey responses, and clinician reports. Overall, the program was tolerable and reviewed favorably by participants. Preliminary pre-post treatment analyses revealed, on average, large reductions in PTSD symptoms as well as significant changes in the target direction on nine of ten outcome measures. These findings encourage further investigation of process-outcome relationships and future, rigorous implementation studies of ACT and exposure integration and culturally and contextually sensitive treatments for military-related PTSD.
AB - A Performance Improvement project conducted within Army Behavioral Health identified significant challenges associated with treating service members diagnosed with posttraumatic stress disorder (PTSD) including unavailability of frequent and consistent therapy, a low completion rate of evidence-based treatment, and a high non-response rate. In response to these findings, clinical staff at Brooke Army Medical Center developed an intensive outpatient program for the treatment of PTSD and combined Acceptance and Commitment Therapy with Prolonged Exposure therapy to create an integrative and uniquely tailored intervention. This project included 311 active duty service members who had not made significant progress in individual outpatient therapy for PTSD. Each participant completed pre- and post-treatment measures of symptoms, functioning, and processes related to psychological flexibility. Program evaluation also included participant interviews, survey responses, and clinician reports. Overall, the program was tolerable and reviewed favorably by participants. Preliminary pre-post treatment analyses revealed, on average, large reductions in PTSD symptoms as well as significant changes in the target direction on nine of ten outcome measures. These findings encourage further investigation of process-outcome relationships and future, rigorous implementation studies of ACT and exposure integration and culturally and contextually sensitive treatments for military-related PTSD.
KW - Acceptance and commitment therapy
KW - Combat trauma
KW - Exposure therapy
KW - Military behavioral health
KW - Military sexual trauma
KW - PTSD
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U2 - 10.1016/j.jcbs.2021.06.002
DO - 10.1016/j.jcbs.2021.06.002
M3 - Article
AN - SCOPUS:85108512241
SN - 2212-1447
VL - 21
SP - 66
EP - 72
JO - Journal of Contextual Behavioral Science
JF - Journal of Contextual Behavioral Science
ER -